Key result
Recurrent infective endocarditis shows no increase in in-hospital or 6-month mortality versus first episodes.
Why the study?
Does recurrent infective endocarditis have different clinical profiles and mortality outcomes compared to first-episode infective endocarditis?
Cohort (n=1,758)
Yes
Does recurrent infective endocarditis have different clinical profiles and mortality outcomes compared to first-episode infective endocarditis?
Absolute Event Rate: 18.9% vs 16.5%
p-value: p=0.297
Recurrent infective endocarditis in Poland is characterized by a higher incidence of negative blood cultures and underutilization of surgery compared to European cohorts, but is not associated with increased mortality compared to first episodes.
Background Patients with prior infective endocarditis (IE) are associated with an increased risk of recurrence. AIMS This study aimed to assess the clinical profile and treatment outcomes of recurrent IE in Poland, through a comprehensive examination of data sourced from the Polish Infective Endocarditis Registry (POL-ENDO) and compare them with European recurrent IE characteristics. Methods A prospective multicenter observational cohort study – the POL-ENDO registry – in IE patients from 160 medical centers in Poland registered between August 2022 and August 2024 was conduct. The demographic, clinical, microbiological and treatment outcome data were assessed. Polish recurrent IE patients were compiled together with those recorded in the ESC-EORP EURO-ENDO registry between January 2016 and March 2018. Results Of a total of 1758 IE patients, 371 were recurrent IE group [21.1%]. Recurrent IE patients were younger than first IE episode patients [62.6±16.2 vs. 58.2±16.6, p<0.001]. Prosthetic valve infective endocarditis (PVIE) predominated among recurrent IE patients [19.7% vs. 33.1%, p<0.001]. Anemia was more prominent among recurrent IE cases [28.4% v. 35.5%, p<0.001]. Fever >38° was observed less often among recurrent IE group [54.1 % vs. 34.8%, p<0.001]. Negative blood culture predominated among recurrent IE cases [27.2% vs. 43.3%, p<0.001]. Staphylococcus aureus was the microorganism most frequently observed in both groups [p=0.12]. Recurrent IE were not associated with the increased in-hospital mortality [18.9% vs. 16.5%, p=0.297] and 6-month mortality [27.9% vs. 24.4%, p=0.190]. The recurrent IE was more predominant in Poland [21,1% vs. 8,6%, p<0.001]. Patients with recurrent IE were less often operated in Poland [55.2% vs. 64.8, P=0.032]. The embolic indication for surgery was less prominent among Polish patients [0.08% vs. 20.2%, p<0.001]. Conclusion The IE recurrence rate in Poland is greater. Fever >38° is less often observed among recurrent IE. Negative blood culture incidence is significantly higher in Poland. Surgical treatment is underutilized among Polish recurrent IE patients. Embolic and uncontrolled infection indications for surgery was underrated in Poland. The recurrence of the IE is not associated with increased mortality.
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Orzech et al. (2025) conducted a cohort in Infective endocarditis (n=1,758). Recurrent infective endocarditis vs. First infective endocarditis episode was evaluated on in-hospital mortality (p=0.297). Recurrent infective endocarditis was not associated with increased in-hospital mortality (18.9% vs 16.5%, p=0.297) or 6-month mortality compared to first-episode infective endocarditis.
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